Sleep Apnea - Risks, Complications, and Testing

Sleep apnea affects approximately 18 million people in the United States. This sleep disorder is marked by periods when breathing stops for 10 seconds or more. The person wakes up suddenly and begins breathing again, however, memories of waking up are not remembered at all. This can occur hundreds of times during then night, resulting in sleep deprivation and feelings of sleepiness during the day.

There are several types of sleep apnea

• Obstructive Sleep Apnea Syndrome (OSAS) - Due to obstruction of the trachea


• Central Sleep Apnea - Improper signals from the brain to the breathing muscles


• Complex Sleep Apnea - A combination of OSAS and Central sleep apnea

The muscles of breathing include:

• The diaphragm


• Transverse


• Erectus


• External oblique


• Internal oblique

Risks of OSAS includes:

• Obesity


• Neck size


• Hypertension


• Gender - More males than females suffer with this sleep disorder


• Age - As you get older your risks for sleep apnea increase


• Heredity


• Ingestion of alcohol, sedatives, or tranquilizers

Risks for Central sleep apnea

• Gender - Being male


• Heart disorders, such as atrial fibrillation (A-fib) or congestive heart failure (CHF)


• Stroke or brain tumor. Accounts for the improper signals from the brain to the muscles of breathing

Complications:

• Heart problems


• Fatigue


• Sleep deprivation


• Post surgical difficulties


• Problems with medications

Other complications include:

• Memory deficits,


• Headaches,


• Mood swings


• Depression


• Nocturia (frequent urination at night)


• Impotence.


• Gastroesophageal reflux disease (GERD)

Testing:

If you suspect that you may have a problem with sleep apnea, you will need to be evaluated and tested to determine if you do have it and what is causing it. Testing includes the following:

Nocturnal polysomnography: Monitors the heart, lung and brain activity, breathing patterns, arm and leg movements, as well as blood oxygen levels.

Oximetry: Monitors and records the oxygen level in your blood.

Portable cardiorespiratory testing: Involves oximetry, measurement of airflow and breathing patterns. This test can be done at home.

Your doctor may also refer you to an otolaryngologist to check for blockages, cardiologist for the heart, and neurologist in cases of central sleep apnea.

Undiagnosed sleep apnea occurs in two percent of the population. Most people do not seek medical help for this sleep disorder, and it is usually recognized initially by the person's bed partner who complains of the loud snoring and inability to get a good night's rest. This results in both not being able to function normally during the day because of the sleep deprivation.

Once a patient is diagnosed with sleep apnea, compliance is another story altogether. Anti snoring and sleep apnea aids are often found to be uncomfortable. Additionally sleep aid appliances may be cost prohibitive due to most insurance companies do not cover them, therefore, the out of pocket expense, which can range up to $1000, may be too much to bear.

by Barb Hicks, RN